Can you be overweight and healthy? This question has been hotly debated in the health and wellness sphere for decades. Some studies appear to suggest that overweight people live longer. On the other hand, a scientific study of 3.5 million Brits published in 2017 found that obese people have an increased risk of developing conditions such as heart disease, stroke, and type 2 diabetes, compared to those of a normal weight. And now, new research carried out by UT Southwestern Medical Center cardiologists, published in European Heart Journal: Quality of Care and Clinical Outcomes, suggests that mildly obese people tend to live longer after a heart attack. That’s right. Being overweight can help you.
The study found that in the three years following a heart attack, mildly obese patients were 30 percent more likely to survive and spend less time in hospital than patients of normal weight. The researchers defined “mildly obese” as having a body mass index (BMI) of 30 to 34.9 kg/m2 (for example, a person who weighs 165 lbs and is 5’2″ tall). Normal weight is considered to be a BMI between 18.5 and 24.9. What’s more, patients of normal weight fared as poorly as those who were extremely obese (with a BMI of 40 or higher). (What is BMI and does it really matter?)
What the findings mean
However, this doesn’t mean heart disease patients (or anyone, for that matter) of normal weight should all be trying to gain weight. Ian Neeland, MD, cardiologist and assistant professor of internal medicine and first author of the study, was quick to put the findings into perspective. “I think the message from this finding is that if you’ve had a heart attack and you’re overweight or mildly obese, you shouldn’t necessarily try to lose weight aggressively in the initial period after the heart attack. The finding does not suggest that heart attack patients should try to gain weight if they are of normal weight,” he says in a news release. “Also, doctors should focus more on heart attack patients who are normal weight and not assume that just because they’re normal weight that they’re probably going to be better off.”
It’s also important to remember that BMI provides only one definition of overweight. Many fitness experts and medical professionals believe BMI to be flawed, because it only gives a rough estimate of body fat, and athletes and gym enthusiasts who carry a great deal of muscle may seem heavy for their height or overall size simply because muscle is denser (heavier) than fat.
Is it healthier to be overweight?
The UT Southwestern study is the latest in a growing body of evidence showing that patients with some chronic illnesses who are mildly obese can have better outcomes compared with people of normal weight—known as the obesity paradox. One theory behind the findings is that overweight patients have more energy reserves to combat the illness. “You’re able to weather the storm better,” says Dr. Neeland. But the researchers also point out that factors other than BMI are likely more important in determining how a patient with heart disease will do.
Of course, the healthiest lifestyle is one that won’t result in a heart attack. Here are 15 life-saving tips to prevent heart disease.